Does Anxiety Mediate the Relationship between Sensory Hyperresponsiveness and Restricted, Repetitive Behaviors during Early Development?

Sensory hyperresponsiveness, anxiety, and restricted, repetitive behaviors are known to be associated with one another, especially in autistic youth, and may be important to the development and presentation of autism over time. Few studies, however, have studied the nature of this three-way relationship prospectively, or in young children at elevated likelihood for autism. The goals of the current study were to gain greater insight into the development of autism from a symptom level before a diagnosis can be made, and specifically, to examine the relationship between sensory hyperresponsiveness, anxiety, and restricted, repetitive behaviors across time during early development in children at elevated likelihood for autism. Extant longitudinal data for a group of children at elevated likelihood for autism (N = 147) were used to conduct path analyses for two mediation model configurations, which included measures of sensory hyperresponsiveness at baseline, and anxiety and restricted and repetitive behaviors at follow-up. Results did not indicate mediating effects for either model; however, higher levels of sensory hyperresponsiveness at baseline were significantly associated with higher levels of anxiety symptoms at follow-up (b = 0.09, SE = 0.04, β = 0.24, p = 0.005, 95% CIs [0.07, 0.40]). Findings suggest that sensory hyperresponsiveness during early development later predicts anxiety symptoms in children at elevated likelihood for autism, which is consistent with prior findings in both autistic (Green et al., 2012) and non-autistic children (Carpenter et al., 2019). Although we are unable to determine whether this is a unidirectional or bidirectional relationship in the current study given the lack of concurrent data on anxiety symptoms at baseline, this result adds to emerging research suggesting that sensory hyperresponsiveness may be a risk factor for later developing anxiety.